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Transcranial Magnetic Stimulation Therapy (TMS)

A modern psychiatric treatment without medication

Transcranial magnetic stimulation is a non invasive treatment modality using a powerful electromagnet to stimulate various parts of the brain.

There are two major types of TMS:

Repetitive TMS (rTMS) that stimulates superficial areas of the brain (typically less than 1 cm)

Deep TMS (dTMS ) that stimulates deeper area of the brain (typically 2-3 cm for the H1 Brainsway™ coil

What to expect During a standard TMS Procedure

The intensity of the magnetic stimulus will be slowly increased to the indicated value to allow you to adjust to the sensations felt during the treatment. Some local discomfort of the scalp, contraction of the scalp and face muscle, movement of the jaw and of the muscles around the eyes are possible. Also you might feel involuntary movements of the arms or hands with the stimulation. Dr Ghelber and Kumud will adjust the intensity of the stimulus and the position of the coil as deemed necessary to achieve maximum benefit with minimal side effects.

Is TMS Right for Me ?

dTMs has been cleared by the FDA for the treatment of resistant major depressive disorder (MDD) and obsessive compulsive disorder (OCD), however different Brainsway™ coils are used for each disease. FDA approved the use of Brainsway™ TMS for the treatment of depressive episodes that showed no satisfactory improvement from the use of antidepressant medication during the current episode of depression. On August 17, 2018, FDA cleared the use of Brainsway™ TMS for obsessive compulsive disorder (OCD) Brainsway recommends the use of an H1 coil for the treatment of MDD and of an H7 coil for the treatment of OCD.

Theta Burst Stimulation (TBS)

TBS refers to a TMS protocol, where pulses are applied in bursts of three, delivered at a frequency of 30-50 Hz and an inter-burst interval of 200 ms (5 Hz). A number of 600 TMS pulses are delivered over a 3 minutes period, significantly shortening the duration of a TMS treatment. In a recent article published in April 2018 in Lancet, it was demonstrated that 600 TMS pulses administered as Theta Burst Stimulation, is not inferior to a standard TMS protocol in the treatment of depression. As such, FDA recently approved the use of Theta Burst in the treatment of major depression for some medical devices. The Brainsway device can deliver a TBS protocol, but the use of this protocol in the treatment of major depression with this device is investigational.